INSTRUCTION MANUAL Reference SL Articulator and Face bow

Transcription

INSTRUCTION MANUAL
Reference SL Articulator and Face bow System
Instruction Manual
Important notice:
For your own safety, as well as for operational safety, please read these i nstructions thoroughly before beginning to operate the device. Always comply with any and all warnings included in these instructions, and/or on the
device itself.
Manufactured by:
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GAMMA medizinisch-wissenschaftliche Fortbildungs-GmbH
A-3400 Klosterneuburg, Josef Brenner-Straße 10
Instruction Manual
Reference SL Articulator System
Revision
October 23, 2008
© Copyright 2008
GAMMA Medizinisch-wissenschaftliche Fortbildungs-GmbH
Josef Brenner Straße 10
3400 Klosterneuburg
Österreich
ph: +43 (0)2243 34140
fax: +43 (0)2243 34140 90
e-mail: [email protected]
Internet: www.gammadental.com
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Instruction Manual
Instructions for Reference SL Articulator and Face bow System
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1
Warnings and safety information..................................................................5
2
Reference AB face bow ...............................................................................6
3
Reference SL Articulator..............................................................................10
3.1
Introduction....................................................................................................10
3.2
Mounting the system ....................................................................................11
3.3
Transferring Upper Jaw Models .................................................................13
3.3.1
According to the anatomic axis (Reference AB face bow) .....................13
3.3.2
Transfer according to the kinematic axis (Condylograph)
3.4
Mounting lower jaw models in the articulator ...........................................24
4
Excentric Articulator Programming ............................................................27
5
Calibration of the Reference SL articulator...............................................31
6
Curve of Spee Analyzer Set........................................................................38
7
Maintenance / Cleaning ...............................................................................44
.................16
1
Warnings and safety information
The instruments are designed for use in the dental practice and lab. Initial start-up
and operation must be according to the instructions manual.
Furthermore it is the owner's responsibility to check up on the adequacy and applicability of the devices for the intended purpose before initial start-up, unless it is
listed in the instructions manual.
The manufacturer does not assume liability for damages caused by improper usage, incorrect handling or improper repair.
All maintenance and servicing, other than operations mentioned in the instructions
manual, should only be done by authorized specialists.
Use original GAMMA spare parts only!
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Instruction Manual
2
Reference AB face bow
The Reference AB face bow (06-230430) is
used for mounting the upper jaw model into the
Reference SL articulator, according to the
anatomic reference plane.
Soften the Bite Tabs (06-642150) in warm water at approximately 45°C and place three of
them on the bite fork. Apply wax to the bite
fork. Place the prepared bite fork onto the upper teeth of the patient in median-sagittal direction with slight pressure on all waxed points.
Try to get equally shallow impressions. The
teeth should not touch the metal fork.
Loosen the nasion. The joint support is not yet
attached to the face bow. Insert the porus supports into the patient's ear canals, allowing the
patient to assist. Tighten the screw to fix the
position.
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The patient moves the face bow gently into the
ear canals.
Stretch the forehead skin. Move the glabella
bridge carefully and without pressure onto the
nasion.
Fix the screw.
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Instruction Manual
To stabilize the face bow you can attach the
retention straps (01-SP0040). Stretch them
equally on both sides and close them at the
back of the head with the hook-and-loop fastener. Control that the face bow fits properly.
Attach the bite fork to the face bow with the
joint support.
Press the bite fork gently to the upper teeth.
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Tighten the toggle nut of the joint in two steps.
Step 1: to fix the bite fork in-situ
Step 2: for the transportation lock.
and
Centralize the toggle and hold the joint support
with the other hand to counter the torque and
to absorb the pressure on the glabella support.
The face bow is in correct position and the joint
support fixed without tension, when the bite
fork will not drop considerably lower from the
upper teeth.
Open the face bow and pull it carefully away
from the patient, in forward and downwards direction. (If retention straps have been used,
open them carefully in advance).
The procedure on the patient is completed.
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Instruction Manual
3
Reference SL Articulator
3.1
Introduction
REFERENCE SL ARTIC ULATOR
06-231380
The Reference SL articulator is an adjustable articulator, designed for use in the dental practice
and lab. The device is used in the spatial mounting and relation of jaw models, in movement
simulation, as well as in additional diagnostics and reconstructive procedures, applicable for
dentists and dental technicians.
The articulator offers a mounting system with integrated magnetic retention, by which models of
the upper and lower jaw can be fixed in specified spatial relations to a coordinate system (e.g.
Frankfort Horizontal facial plane). The SL articulator is equipped with both right and left condylar joints, for movement simulation. These elements are individually interchangeable in their
characteristics, and offer the possibility of defining the inclination angles for both the sagittal as
well as the transversal components of the guidance.
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3.2
Mounting the system
REFERENCE Distance blocks
06-231510-(pair, horizontal 1)
06-231511-(pair, horizontal 2, +8mm)
06-231512-(pair, horizontal 3, 16mm)
06-231520-(pair, slanted A)
06-231521-(pair, slanted B, +8mm)
06-231522-(pair, slanted C,+16mm
REFERENCE Mounting plates
06-231550 (50 pc.)
The mounting blocks and the attached mounting plates are used in fixing the cast models to
the upper and lower articulator units, to establish the necessary retention for the cast.
The mounting plates must be screwed to the
mounting blocks with the 2,5mm allen key.
The mounting plates are disposable parts,
and should be stored with the models.
The mounting blocks are designed for multiple
use, and can be screwed into and unscrewed
from the mounting plate.
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Instruction Manual
To enable exact identification of the mounting
block, the type of base used and its position
are encoded in the cast. When remounting a
block, the correct type and position can be
easily determined.
Nevertheless, for reasons of precision, it is recommended that the mounting blocks and
mounting plates are not separated until after
completion of the case. For manufacturing
technological reasons, the mounting blocks
and plates may differ slightly!
To mount the block into the articulator, the
block is placed at the back attachment line,
and then lowered and locked to the guiding
pins.
The block is retained by the magnet, located
in a metal case, built into the articulator.
Removing the blocks must only be done with
the red release buttons. Incorrect ejection of
the blocks (e.g. by tilting or turning) can cause
the block to detach from the mounting plate!
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3.3
Transferring Upper Jaw Models
3.3.1 According to the anatomic axis (Reference AB face bow)
After taking off the face bow from the patient,
remove the porus supports from the side arms,
thus making the mounting registrations
(adapter plates) accessible.
Close the centric locks (left and right) of the articulator. For more exact results, we recommend that you insert the black SCI inserts into
the condylar housings in advance. The articulator should be adjusted symmetrically (e.g., 40°
SCI).
Preparing the articulator for mounting: first, remove the incisal table and the incisal pin; then,
the face-bow support (06-230480) and the bite
fork support (06-230585) must be attached.
The correct position of the face-bow support is
achieved, when the writing can be read normally. The supporting beams of the bite fork
support, equipped with a pressure spring, must
be moved downwards and fixed.
The upper part of the articulator remains open,
resting on the upper index pin.
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Instruction Manual
Move apart the side arms of the Reference AB
face-bow leading parallel, and remove the nasion support from the bow.
The adaptor plates can now be tilted and fixed
to the corresponding casings. To do so, the
Reference AB face–bow is pushed together
gently but firmly, until both guides slide firmly in
place on the articulator, without wobbling. After
locking it in place, the face-bow is placed on
the bow support, and the anterior bow fixing
screw is tightened, thus locking the bow.
Now the bars of the bite fork supports can be
moved upwards, until they touch the bite fork;
then they can be fixed. The position of the bite
fork must not be altered.
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The next step is selecting the ideal mounting
block. First, the upper jaw model must be set
into the corresponding impressions on the bite
fork; then close the upper section of the articulator that it rests in solid contact on the anterior
face-bow pins. Analyze the distance between
the upper section and the model. The mounting
block which best fills the spatial requirements
can now be chosen. Make sure that there is a
thin, but even layer of plaster on the selected
block. This will minimize the distortion effects of
plaster expansion.
The articulator can now be opened and the
mounting block, with mounting plate already
attached, can be fitted in. Moisten the model,
and make sure to apply sufficient mounting
plaster on both the mounting plate and the
model.
Close the articulator and allow the plaster to
harden, according to instructions.
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Instruction Manual
The Reference AB face-bow can now be removed from the articulator.
3.3.2 Transfer according to the kinematic axis (Condylograph)
Mounting the upper jaw model in the Reference SL articulator, according to the kinematic
(exact) hinge axis and individual reference
plane, is carried out, using the Reference
condylograph system (04-GCR009).
With the GAMMA Reference condylograph
system, you can localize both the right and left
hinge axis points directly on the patient, and
mark them on writing labels stuck to the red
recording plates.
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In addition, the anterior reference point is
marked with the reference point indicator.
With these 3 points (anterior reference point,
right and left hinge axis points) you can create
a reference plane with a zero-line (hinge axis
in Reference Position), which will be transferred into the articulator as follows:
The bite fork must be attached, with the im pressions exactly positioned on the teeth.
Then, connect the bite fork to the upper facebow.
Please check that all of the face-bow screws
are tightened correctly. Then the elastic band
can be opened, and the face-bow should be
carefully pulled away from the patient, forward
and down.
The red recording plates, marked with the axis
points, can be mounted.
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Instruction Manual
Then mount the axis indicator holder to the
upper face-bow, and fix and adjust the axis
needles to the marked axis point.
Now the red recording plates may be removed.
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Before inserting the face-bow on the transfer
stand, the nasion support must be removed.
Centering the model in the articulator: the
slide on the distance ruler must be moved
completely to the end, and then fixed.
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Instruction Manual
Insert the ruler on one side by attaching the
slot of the ruler onto the corresponding needle
of the axis indicator holder.
Now you can read the distance to the other
side on the 2mm scale of the ruler.
.
It is important to use the correct measuring
edge.
The slide on the ruler has to be positioned exactly on the 1mm scale, according to the
measured value, and then fixed there.
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Preparing the transfer stand: the attachment
screws of the two axes (brass elements) must
be loosened, so that the axis springs push
them completely to the ends. The bars of the
built-in bite fork support must be moved completely to the bottom. The height setting of the
upper section is turned to the top.
The distance of one axis is set and fixed with
the ruler (previously centered). The other axis
remains open.
Insert the face-bow with the axis pin into the
bore of the open axis, and move it towards the
center, until it is possible to hook in the fixed
axis of the other side.
The second axis can now be locked. The two
axes must be positioned in equidistance.
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Instruction Manual
The face-bow is now resting on the bite fork
joint, propped up on the white pedestal. Carefully move the bars of the bite fork support
upwards to the bite fork, for further stability.
The reference plane adjustment reed is fixed
on the upper section of the transfer stand
through magnetic retention.
.
Lower the upper section of the transfer stand
by turning the adjustment screw, until the reference plane adjustment reed slightly touches
the anterior ball of the reference point indicator.
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Remove the reference plane adjustment reed
and the reference point indicator. Now you
can insert the upper cast into the corresponding imprints in the bite fork. After closing the
transfer stand, you can analyse the distance
between the upper section and the model.
Choose the best-fitting block. Make sure that
the layer of plaster is as thin as possible. This
will minimize the distortion effects of plaster
expansion.
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Instruction Manual
Open the articulator and fit in the mounting
block, with a mounting plate already attached.
Moisten the model, and make sure to apply an
adequate amount of plaster on both the
mounting plate and the model. Close the
transfer stand, and allow the plaster to
Now, you can remove the model from the
transfer stand and insert it into the Reference
SL articulator, for mounting the lower jaw
model.
3.4
Mounting lower jaw models in the articulator
Mounting the lower jaw, relative to the axis, is
carried out in the Reference SL articulator. To
achieve a stable position of the articulator on
the head, and to avoid errors due to manual
handling, attach the mandible mounting clamp
(06-230566) to the upper part of the articulator.
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Lock the articulator in centric and place it upside down on the table; then place the registration on the upper jaw model carefully.
Insert the lower jaw model into the registration
imprints.
By examining the central marking area of the
articulator, you can estimate (or better, measure) to what extent the occlusion is locked by
the centric record.
The supporting pin must be pulled out to twice
the amount indicated, starting at the zero line
(locked).
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Instruction Manual
Select the mounting block which corresponds
to the mounting of the upper jaw. Open the
articulator, and insert a mounting block with a
previously attached mounting plate.
Moisten the model, and apply an adequate
amount of plaster on both the mounting plate
and the model.
Close the articulator and allow the plaster to
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4
Excentric Articulator Programming
Program set Reference SL
06-231310
Spare parts:
06-231321TCI insert- b
06-231322
TCI insert- white
(straight)
06-231323
TCI insert- yellow
(curve A – slight curve)
06-231324
TCI insert- red
(curve B –medium curve)
06-231325
TCI insert- blue
(curve C – strong curve)
06-231331
open)
06-231332
06-231333
06-231334
06-231335
06-231341
06-231342
06-231343
06-231344
06-231345
SCI insert - white
(radius 18 mm, surtrusiv e
SCI insert - yellow
(radius 18 mm, retrusive open)
SCI insert - red
(radius 18 mm, detrusiv e open)
SCI insert - blue
(straight, retrusive/surtrusive
open)
SCI insert - black
(Radius 18 mm,
retrusive locked)
protrusion stop
yellow (1 mm)
protrusion stop
red (2 mm)
protrusion stop
blue (3 mm)
protrusion stop
green (4 mm)
protrusion stop
black (5 mm)
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Instruction Manual
Programming excentric movement tracks into
the Reference SL articulator is carried out with
the Reference SL program set.
Programming can be based on an average
value or, preferably, on individually ascertained mandibular joint data (CADIAX ), but
can also be based on other data, including
therapeutic criteria.
The Reference SL articulator guidances consist of different SCI and TCI inserts (sagittal
and transversal guidance elements) and their
adjustable angles, in relation to the reference
plane.
The Reference SL condylar housings are designed to allow for n
i dividual interchange of
the inserts. In addition, the program set also
includes so called “protrusion stops”. These
elements allow for the exact protrusive positioning of the lower jaw, in 1 mm increments.
The GAMMA CADIAX calculation table provides an easy and effective means of identifying excentric articulator value settings for the
individual patient.
Based on electronic registrations of protrusive
and mediotrusive movements, the system calculates both the ideal angle setting, and the
optimal TCI or SCI insert.
Fixing and adjusting the SCI insert:
First, separate the upper and lower sections
of the articulator; then, remove the centric lock
and detach the exchangeable insert by pressing it lightly forward. Now, hold the new insert
at an angle, and attach it to the guidance by
sliding it forward slightly, until it clicks in.
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To adjust the angle, first loosen the condylar
housing fixing screw. Set the desired value on
the scale, then tighten the screw again.
Fixing and adjusting the TCI insert:
Simply pull out the old insert from the groove
and slide in the new insert.
To set the angle, loosen the TCI attaching
screw on the condylar housing back panel.
Set the value on the scale, then tighten the
screw again.
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Instruction Manual
Protrusion stops:
The protrusion stops help to force the lower
jaw section of the articulator into exact joint
related protrusive positions.
The protrusion stop is attached to the condylar element of the articulator from the outside
and closed by clicking it in over the articulator
axis. The beveled front of the stop always
points inwards, in order to also allow for
asymmetric positions.
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5
Calibration of the Reference SL articulator
(for devices from serial no. 070001)
Required parts and material:
Reference adjustment set
(art.no. 06-231386)
Articulator axes (art.no. 06-231349A)
Casings (art.no. 06-231349H)
Reference calibration key (art.no. 06-231900)
Plaster GC Fuji-Rock Type 4, plaster injection
Step 1:
Preparation of the lower part of the articulator
Remove the old axes and casings. Clean the
articulator.
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Instruction Manual
Step 2:
Insert and fix the new casings
Insert the casings on both sides from the outside into the boring of the lower jaw section of
the articulator and screw them tightly.
Step 3:
Preparation of the condylar housings
Insert white TCI inserts into the condylar
housings on both sides. Adjust the angle at
40° SCI and 10° TCI. No condylar inserts to
be attached.
Step 4:
Attach and fix the adjustment blocks
Attention: inserting direction as shown in adjoining picture!
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Step 5:
Lock the upper and the lower part of the articulator in centric zero position with the calibration key.
Attention: Clean the groovings of both the
calibration key and the articulator
in advance. The key must be
locked tightly!
Dismantle in advance the incisal
table and incisal pin!
Step 6:
Prepare the O-rings of the articulator axes.
Move the o-rings into a slightly medium position. (see adjoining picture!)
Step 7:
Insertion and fixing of articulator axes and adjustment blocks
a) insert the axes into the bore of the adjustment blocks
b) Apply counter pressure with the other hand
(see adjoining picture!)
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Instruction Manual
c) Axis has to be in precise contact with the
TCI insert.
d) Tighten the fixation screw.
Step 8
Slide-in the centric o-ring.
Advice: make a screwing movement for an
easier application of the red casing.
- 34 -
Step 9:
Fix the axes with plaster GC Fuji-Rock type 4.
The plaster should have a viscous consistency. Wipe off overflow.
Step 10:
Allow the plaster to harden for 30 minutes at
least.
Step 11:
Open the screws of the adjustment blocks and
remove them in outwards direction.
Step 12:
Open the adjustment key. Remove the key
and the upper part of the articulator.
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Instruction Manual
Step 13:
Equip the condylar housing with a white SCI
insert and and a centric lock.
Step 14:
Remove the adjustment blocks and attach the
retaining collars to the axes.
- 36 -
Step 15:
Fix the retaining collars.
Equip the articulator with the incisal table and
incisal pin.
Connect upper and lower section and close
the centric lock.
Move the retaining collars to the centric locks
and fix them with an allen key from back and
below.
Ready !
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Instruction Manual
6
Curve of Spee Analyzer Set
The curve of Spee analyzer serves for analysing the sagittal compensation curve in the
area of the posterior teeth of the model. The
templates may not directly be used for patients. The application is for the Reference SL
articulator only.
The set (Art.-Nr. 04-000019) includes 7 templates with radii from 60 to 90 mm in steps of
5 mm and an axial support pin for the Reference SL articulator.
(The shown pedestal is not included in the
set. It can be ordered as a special spare part.)
Preparation:
Firstly separate the upper and the lower section of the Reference SL articulator. Remove
the incisal pin.
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Place the axial support pin in centric position
on the articulator axes……..
…and press it onto the axes with light pressure until it locks in place.
The application is done with the (preferably
pinned) lower jaw model.
All teeth which are not necessary for the task
should be removed in advance.
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Instruction Manual
Each template has two function areas:
A.
B.
- 40 -
Axis bearing area (contact line
with scaling for the axial support pin)
Radius sector
(contact line of the cusps)
Depending on the respective school of
thought the template is attached with the radius sector in relation to the anatomic/morphologic dental cusps. (according to
Slavicek: canine cusp and distobuccal cusp of
the first molar)
The radius is corresponding to a circle with
the radius mentioned on the template
(the adjoining picture shows a template R =
60mm)
The curve of the axis bearing area differs
considerably from the curve of the radius sector.
By rotating the template without losing contact
with the axis bearing pin, you can move the
position of the circle in relation to the axis of
the articulator.
Scaling: If the template touches the axis
bearing pin (grey) in position 0, the imaginary
circle of Spee runs exactly through the hinge
axis of the articulator. With the contact point in
the negative area the scale displays the distance in mm of the circle moving behind the
hinge axis, contact in the positive area of the
scale shows the distance of the circle in mm
of the circle moving in front of the hinge axis.
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Instruction Manual
With a constant anterior contact point the result of the described rotation is in principle as
follows.
Occlusal plane is lowered posteriorly.
Disocclusion angle increases.
Disocclusion angle declines.
Occlusal plane is raised posteriorly.
- 42 -
The previously shown changes in direction
neither include the actual individual condylar
guide inclination of the patient (CADIAX), nor
the analysis based on caphalometric data
(CADIAS).
These parameters should always be taken into account in analysis and planning.
Literature:
J.P. Re, C. Perez, A. Giraudeau,. P.Ager, A.El
Zoghby, J.-D. Orthlieb
Reconstruction of the curve of Spee
Stomatologie (2008) 105: 29-32
- 43 -
Instruction Manual
7
Maintenance / Cleaning
Clean the Reference SL articulator system and face bow gently and without using solvents. For
a long-lasting function of the articulator it is not necessary to use lubricants.
The instruments should not get in contact with strong acids, avoid cleaning it in an ultrasonic
bath.
Do not use corrosive liquids, scrubbing brushes, wire brushes or similar materials!
Only use cleaning agents suitable for disinfecting and cleaning light alloys (The reaction times
are listed in the manufacturers' instruction.)
Sterilization must be carried out in an autoclave: 5 mins. at 134º C, 20 mins. at 120 º C
Preparing for use:
Bite fork: Disinfect in a disinfecting tank or use disinfectant spray. Clean the registration material off the bite fork. If a thermoplastic material has been used, it is advisable to place the bite
fork in a refrigerator. The regristration material is then easier to remove from the bite fork.
Sterilize in an autoclave.
Nasion with glabella support: Spray the nasion with disinfectant. Wash off any remaining under
running water. May be autoclaved, but is not absolutely essential.
Porus supports: unscrew the porus supports and immerse them in disinfectant. The porus supports are best cleaned with a steam cleaner. To steam the hole, hold the nozzle of the steam
cleaner in the acoustics hole and spray it clean. May be autoclaved, but is not absolutely essential.
- 44 -

INSTRUCTION MANUAL Reference SL Articulator and Face bow

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